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Medical officer’s opinion

Medical officer's opinion, challenging medical evidence, lawyers, courts
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Whenever there is a medical examination, one of the most crucial things is the final opinion. So how do we frame this final opinion? In case of a survivor, formulating this final opinion, so the law mandates a reasoned opinion. So both the 164A CrPC for victim examination and 53A CrPC for an accused examination, put out very clearly that every medical officer should give a reasoned opinion. So every word uttered in the final opinion should have a scientific basis. The Ministry of Health and Family Welfare Guidelines issued in 2014, have given clear templates how a medical officer can formulate the final opinion, or even the provisional opinion immediately after the examination and after receipt of the laboratory investigations.
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How final opinion can be given in different scenarios like penile penetration, non-penile penetration and even in non-penetrative sexual violence. So all stakeholders can refer to that in understanding the opinions, what are being listed after survivors sexual violence examination.
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Having understood the process of medical examination and the manner in which examiners should record their opinion, we now move on to how lawyers can analyse the medical examination reports in their cases. First, How long after the crime was the medical examination conducted? The lessons highlight that delay in conducting medical examination can lead to loss of evidence. Therefore, it is important to ascertain the time gap between the offence and medical examination of the victim and accused. Second, you should see - could there have been loss of evidence in the period between the offence and medical examination? Bathing, urinating, washing genitals, changing clothes by the victim or accused can have a bearing on collection of evidence.
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Therefore, it is important to note the activities undertaken by the victim and accused between the offence and the medical examination. Third, in case of a deceased victim, it is important to see how the activity at the crime scene or improper crime scene management could have impacted the quality of evidence which is collected from the deceased victim. Fourth examine the findings on injuries on the victim and accused, if any, and correlate it with the testimonies and recoveries in the cases. In doing so, note how the injuries have been described. In case of examination of a survivor, has the medical examiner provided details about the site, shape, size and colour of all injuries?
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In case of the deceased victim, has there been a detailed post mortem examination? Such an examination should include external and internal examination of the body, with detailed descriptions in the autopsy report.
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However, remember, that the absence of injuries does not necessarily mean that no sexual offence took place. Fifth, it is important to see what type of evidence was collected from the victim and accused? What reasons were there for the medical examiner to collect some types of evidence and not others? Sixth, you should see what evidence was sent to the forensic science lab for examination? Was all the evidence which was collected sent for examination? It is also important to know the time gap between collection of evidence from the victim and accused and when it was sent to the laboratory? If there was a delay, what was the reason for such delay? Seven, how was the opinion recorded?
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Remember, whether rape has occured is a legal issue and not a medical finding. The opinion of the medical examiner cannot be stated in terms of whether rape has occured or not. The opinion should be reasoned and should have a scientific basis. Lastly, as stated by Dr Narayanareddy, the Ministry of Health and Family Welfare guidelines provide a template of how a medical examiner’s opinion should be formulated. It is important for you as lawyers to go over these guidelines and see if the process of medical examination and manner of stating the opinion has been adhered to in your case. However, remember, that the absence of injuries does not necessarily mean that no sexual offence took place.
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Fifth, it is important to see what type of evidence was collected from the victim and accused? What reasons were there for the medical examiner to collect some types of evidence and not others? Sixth, you should see what evidence was sent to the forensic science lab for examination? Was all the evidence which was collected sent for examination? It is also important to know the time gap between collection of evidence from the victim and accused and when it was sent to the laboratory? If there was a delay, what was the reason for such delay? Seven, how was the opinion recorded? Remember, whether rape has occured is a legal issue and not a medical finding.
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The opinion of the medical examiner cannot be stated in terms of whether rape has occured or not. The opinion should be reasoned and should have a scientific basis. Lastly, as stated by Dr Narayanareddy, the Ministry of Health and Family Welfare guidelines provide a template of how a medical examiner’s opinion should be formulated. It is important for you as lawyers to go over these guidelines and see if the process of medical examination and manner of stating the opinion has been adhered to in your case.

In this video, Dr Narayanareddy discusses how medical officers should record their opinions. Thereafter, Devina Malaviya from Project 39A discusses the important aspects that lawyers must consider while examining medical opinions in their casework.

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Decoding Forensics for Legal Professionals

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